Tag: autism feelings

Flat Affect

I missed this one, I think!

I have been trying to learn if there is a link between Parkinsonism’s “mask” and Autism’s frequent reports of flat affect.

Flat affect is simply a lack of expressivity in one’s face and reactions.. the lack of showing emotion in one’s “presentation” to the world. Flat affect is reported as being frequent among autistic people.

I was quite surprised when the Doctor who diagnosed my autism said in the summary report that I “presented with flat affect”. I had always thought I was quite expressive both in my face and body, and in my voice! I certainly feel emotions, and was amazed that these emotions are not clearly visible on my face and in my reactions, etc in interactions with others, etc.

My mother was diagnosed with Parkinson’s while she was in her mid 50’s partly because she appeared to show “the mask” or flat affect that is known to develop with Parkinson’s disease… and knowing of her autism, I am now wondering if the flat affect due to her autism was perhaps attributed instead to Parkinson’s.

Flat affect might be one reason that autistic people are often accused of being cold.. our emotions may not be evident to others because of flat effect… NT people generally are very facially expressive of emotions and looking at one’s face is often a giveaway to one’s thoughts ( one being a person or an individual). When other people can not see our emotions clearly displayed on our faces, it is assumed that we are unfeeling. This is often far from the truth!

If you have been accused of ‘Not caring, being cold, being heartless, unreceptive, detached,” or otherwise unfeeling, yet you know you feel emotions sometimes desperately, perhaps flat affect is present. Did you know? I did not!

Autism and Interoception

How are you feeling?

Have you ever heard of interoception?
This a sensory function which is still being described, and there is still some disagreement over what its definition should include.

Interoception is the sense of your inner self which includes the ability to feel what is going on inside you.

The initial definitions were about giving a person ability to recognize inner physical symptoms of needs: when you felt hungry, thirsty, needed to go to the bathroom, felt pain or discomfort in your internal workings.

The definition has been refined over time and using recent studies now includes also your emotional status.

Studies are in the initial stages but tend toward showing that neurological ties to the inner body are the same that are used for ‘feeling’ emotions, and that yes, emotions are tied to physical feelings as well.


We all know that, if we think about it. Tension headaches, anxiety stomach aches, the burning that comes with anger and the churning gut of distress, and how do you suppose the term ‘heartache’ was coined?

Right now there is debate over which comes first, the physical sensations or the emotional processes involved in recognizing ones “feelings”. Some scientists are saying that the physical responses are the initial ones which cause us to then recognize the emotions behind them.

I think the jury is still out on that idea, but it is interesting to think about the implications.


Interoception as it is described today is related to recognizing physical and emotional status of our inner selves. It is the neurological sense that tells us ‘how we feel’ in the most literal way.

How is this likely to be tied to autism?

Interoception is believed to exist because of human neurology. It is being defined as another sense.
We are equipped with an internal monitor through a network of nerves which sense and report “how we feel”.

Autism being a function of neurology and strongly tied to sensory processing, can show its effects in any part of the human neurological system.
Many autistic people are not good at recognizing when they are hungry, thirsty, tired, whether their bladder is full, and on and on.
We are notoriously poor at sorting our emotions as well.
All of these issues are related to interoception because they are all issues of sensory processing within us.

I will use imaginary Sally as an example.
Sally was late to be toilet trained, she simply was not able to tell when she ‘had to go”. She often wet the bed. Her body did not wake her when her bladder was full because it did not recognize that discomfort.
Sally had a ruptured appendix when she was 25, and did not recognize the abdominal ache, which she reported as vague and undefined. She finally had uncontrollable vomiting which drove her to the emergency room where she was barely in time for her life to be saved by immediate surgery.
Sally will get so involved in a project that she forgets to eat, and when she finally does eat, she does not know when to stop, often getting sick from overeating.
She is known for her volatile temper and her extreme emotional outbusts.
All those struggles are likely to have their base in processing input from her interoceptive system.

Do you have signs of interoceptive struggles in your own life?